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Table of Contents
Intro
Foreword
Preface
Contents
Contributors
Part I: Identification and Characterisation of High-Risk Surgical Patients
1: Defining the High-Risk Surgical Patient
References
2: The Frail Patient in the Operating Room: Practical Steps to Reduce the Operative Risk
2.1 Introduction
2.2 Frailty and Surgery: The Game Changer
2.3 Frail Assessment Tools: In Need for Feasibility to Expand the Recognition
2.4 Frailty, Ageing, and the High-Risk Surgical Patient
2.5 Frailty and Surgery in Elderly Patients: The New Comprehensive Paradigm
2.6 How to Improve the Outcomes of the Older Frail Surgical Patients
2.7 Physical Performance
2.8 Nutrition
2.9 Mental Health and Cognitive Dysfunction
2.10 Solid Organ Transplant Surgery and Frailty: Times Are (a)Changing
2.11 Conclusions
References
3: The High Risk Surgical Patients: The Pathophysiologic Perspective
3.1 Anemia
3.2 Pathophysiology of Oxygen Debt
3.3 Conclusions
References
4: Monitoring and Interpretation of Vital Signs in the High-Risk Surgical Patients
4.1 Heart Rate
4.1.1 Heart Rate and Circulating Blood Volume
4.1.2 Heart Rate and Increased O2 Demand
4.2 Blood Pressure
4.3 Respiratory Rate
4.4 Body Temperature
4.4.1 Effector Organs Response to Increased Body Temperature
4.4.2 Effector Organ Responses to Decreased Body Temperature
4.4.3 Effects of Body Temperature Changes
4.5 Pulse Oximetry
References
5: Evaluation and Critical Care Management of the Burn Patient
5.1 Introduction
5.2 Burn Category
5.3 Burn Extention Measurement
5.4 Pathophysiology of Wound Healing [2-5]
5.5 Shock: Ebb and Flow Phase
5.6 Sepsis
5.7 Inhalation Injury
5.8 First-Line Treatment
5.9 On Admittance
5.9.1 Primary Survey
5.9.2 Secondary Survey
5.10 Resuscitation from Burn Shock
5.10.1 Standard Monitoring Criteria
5.11 Nutrition [5, 8, 9, 12]
5.12 Wound Covering [4, 5, 8-10, 12]
5.13 Surgical Management
5.14 Criteria for Transfer a Patient to a Burn Centre [8, 9]
5.15 Clinical Scenario
5.15.1 Put the Actions in Order
5.15.2 Choose the Most Correct Answer
5.15.2.1 Choose the Correct Answer
5.15.3 Choose the Correct Solution
References
6: Acid-Base Abnormalities in Surgical Patients Admitted to Intensive Care Unit
6.1 Introduction
6.2 Metabolic Acid-Base Disorders in Surgical Patients
6.2.1 Metabolic Acidosis
6.2.1.1 Clinical Manifestations
Lactic Acidosis
Lactate Metabolism
Mechanisms of Anaerobic Lactate Production
Mechanisms of Aerobic Lactate Production
Treatment of Lactic Acidosis
Unmeasured Anion Acidosis
Ketoacidosis
Post-surgical Euglycemic Diabetic Ketoacidosis
Hyperchloremic Metabolic Acidosis
Foreword
Preface
Contents
Contributors
Part I: Identification and Characterisation of High-Risk Surgical Patients
1: Defining the High-Risk Surgical Patient
References
2: The Frail Patient in the Operating Room: Practical Steps to Reduce the Operative Risk
2.1 Introduction
2.2 Frailty and Surgery: The Game Changer
2.3 Frail Assessment Tools: In Need for Feasibility to Expand the Recognition
2.4 Frailty, Ageing, and the High-Risk Surgical Patient
2.5 Frailty and Surgery in Elderly Patients: The New Comprehensive Paradigm
2.6 How to Improve the Outcomes of the Older Frail Surgical Patients
2.7 Physical Performance
2.8 Nutrition
2.9 Mental Health and Cognitive Dysfunction
2.10 Solid Organ Transplant Surgery and Frailty: Times Are (a)Changing
2.11 Conclusions
References
3: The High Risk Surgical Patients: The Pathophysiologic Perspective
3.1 Anemia
3.2 Pathophysiology of Oxygen Debt
3.3 Conclusions
References
4: Monitoring and Interpretation of Vital Signs in the High-Risk Surgical Patients
4.1 Heart Rate
4.1.1 Heart Rate and Circulating Blood Volume
4.1.2 Heart Rate and Increased O2 Demand
4.2 Blood Pressure
4.3 Respiratory Rate
4.4 Body Temperature
4.4.1 Effector Organs Response to Increased Body Temperature
4.4.2 Effector Organ Responses to Decreased Body Temperature
4.4.3 Effects of Body Temperature Changes
4.5 Pulse Oximetry
References
5: Evaluation and Critical Care Management of the Burn Patient
5.1 Introduction
5.2 Burn Category
5.3 Burn Extention Measurement
5.4 Pathophysiology of Wound Healing [2-5]
5.5 Shock: Ebb and Flow Phase
5.6 Sepsis
5.7 Inhalation Injury
5.8 First-Line Treatment
5.9 On Admittance
5.9.1 Primary Survey
5.9.2 Secondary Survey
5.10 Resuscitation from Burn Shock
5.10.1 Standard Monitoring Criteria
5.11 Nutrition [5, 8, 9, 12]
5.12 Wound Covering [4, 5, 8-10, 12]
5.13 Surgical Management
5.14 Criteria for Transfer a Patient to a Burn Centre [8, 9]
5.15 Clinical Scenario
5.15.1 Put the Actions in Order
5.15.2 Choose the Most Correct Answer
5.15.2.1 Choose the Correct Answer
5.15.3 Choose the Correct Solution
References
6: Acid-Base Abnormalities in Surgical Patients Admitted to Intensive Care Unit
6.1 Introduction
6.2 Metabolic Acid-Base Disorders in Surgical Patients
6.2.1 Metabolic Acidosis
6.2.1.1 Clinical Manifestations
Lactic Acidosis
Lactate Metabolism
Mechanisms of Anaerobic Lactate Production
Mechanisms of Aerobic Lactate Production
Treatment of Lactic Acidosis
Unmeasured Anion Acidosis
Ketoacidosis
Post-surgical Euglycemic Diabetic Ketoacidosis
Hyperchloremic Metabolic Acidosis